Gear activated trocar assembly

ABSTRACT

A trocar assembly is disclosed for use in inserting a laparoscopic instrument into the abdominal cavity during surgery and includes a cylindrical member activated by intermeshing gears to expand a cylindrical member having a normally retracted outer diameter when the trocar assembly is within the abdominal cavity, to resist withdrawing movement of the assembly from the abdominal cavity.

This is a continuation of application Ser. No. 08/029,372, filed Mar. 8,1993, now abandoned, which is a continuation of application Ser. No.07/705,110, filed May 24, 1991, now U.S. Pat. No. 5,217,451.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention is directed to a medical device, and, moreparticularly, to a trocar assembly which can be inserted a shortdistance into the abdominal cavity and expanded to prevent the devicefrom sliding in and out of a surgical incision.

2. Brief Description of the Prior Art

Endoscopic surgical procedures gain access to the inside of ananatomical cavity by first using an implement, such as a trocar spike,cannula or a needle having a sharpened point to pierce or puncture thebodily tissues, muscles, membranes, or the like, which may form aportion of or surround, the cavity wall.

Similarly, in many endoscopic procedures, a small incision may be madein the skin of a patient along the abdomen, for example, and the sharppoint of a larger penetrating implement, such as a trocar spike ofsuitable length and diameter, may be inserted into the incision, andpushed until the point punctures the cavity wall. Thereafter, a sleeveis slid over the exterior surface of the implement into the puncturewound to serve as a lining for preserving the shape of the passagewaycreated by the implement and for insertion of an endoscope, laparoscope,or the like, to view and operate upon organs within the cavity.

In many such applications, a trocar is used which incorporates a sleevewhich may have a tendency to slide in and out of the incision in theabdominal wall, particularly when the surgeon is trying to move thelaparoscopic instrument through the interior of the trocar sleeve intoor out of the abdominal cavity.

One solution to such prior art deficiencies is discussed in U.S. patentapplication Ser. No. 440,199, filed Nov. 22, 1989, now U.S. Pat. No.5,122,122, entitled "Locking Trocar Sleeve" and assigned to the sameassignee as the present invention. In such application, concentricsleeves are disclosed, with the outer of the sleeves being manipulatablebetween contracted and expanded outer diameters to form a mushroom-likeconfiguration at the distal end of the device which has been insertedinto the abdominal cavity, such that resistance to withdrawal movementsis effected when the surface of the mushroom contacts an abdominal wall.The activation of the mushroom is effected by a comparatively complexrotational or other mechanism, as disclosed. Moreover, the outer memberwhich is "mushroomed" is not the member which, itself, is directlyactivated.

The present invention addresses the deficiencies of the prior art, asset forth above.

SUMMARY OF THE INVENTION

In the present invention, a trocar assembly is provided for use ininserting an endoscopic instrument into the abdominal cavity. Theassembly comprises a housing with first and second elongate cylindricalmembers having first ends mounted through the housing. The cylindricalmembers are concentrically disposed relative to one another. One of thecylindrical members defines a passageway for receipt of an auxiliarysurgical instrument therethrough. One of the cylindrical members has asecond end with a first normally retracted external diameter selectivelyexpandable to a second enlarged external diameter to resist withdrawalof the assembly from within an abdominal cavity when the externaldiameter of said one of the cylindrical members is selectively expanded.The one of the said members has a first gear member including firstinter-engageable means, while a second gear member is carried on thehousing and has a second inter-engageable means, such as intermeshingteeth, for companion interfacing with the first inter-engageable means.

The gear means are manually non-rotatably manipulatable to move thesecond end of the cylindrical member between the retracted and enlargeddiameters.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a sectional schematic illustration of the apparatus of thepresent invention in position prior to insertion into an abdominalcavity, with the cylindrical members being in normally retractedposition relative to one another.

FIG. 2 is a view similar to that of FIG. 1, but illustrating theposition of one of the cylindrical members relative to the other whenthe one cylindrical member's outer diameter is expanded, such assubsequent to insertion through the abdominal wall into the cavity,during surgery.

FIG. 3 is a prospective illustration of one of the cylindrical membersand sleeve and an inter-engaging gear means.

FIG. 3A is a view similar to that of FIG. 3, illustrating the positionof the respective components during activation such that the outercylindrical sleeve is in expanded position.

FIG. 4 is an outer perspective view of the apparatus of the presentinvention illustrating, in particular, the manual manipulating meansthrough the housing and the seal assembly for insertion of an auxiliaryinstrument, such as a laparoscope.

FIG. 5 is a view similar to that of FIG. 4, showing the insertion of anauxiliary instrument, such as the laparoscope.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Now with first reference to FIG. 1, there is shown a trocar assembly 10having a housing 11 with an upper opening 32 defined therein for receiptof the outwardmost end of a hand-manipulatable control assembly 33. Thehousing 10 has a distal end with an abutment skirt 11A thereonterminating in a receptacle 11B for receipt of first and secondconcentrically disposed cylindrical members 12 and 13 therethrough andinto the housing 11.

A passageway 16 extends completely through the assembly 10 and theinnermost of the cylindrical members 13 to an opening 15. An end 14 isdefined on the distal end of the first elongate cylindrical member 12,which is inserted into the abdominal cavity. As shown in FIG. 1, thefirst elongate cylindrical member 12 has a retracted outer diameter 17.

Now referring to FIG. 2, the first and second elongate cylindricalmembers 12 and 13 are secured, one to another by means of securements 30radially spaced there-across at the distal end, such as by spot welding,or the like.

The first elongate cylindrical member 12 carries thereon a portionwithin the housing 11 defining a gear member 19 having inter-engagingteeth at 20 thereon and, preferably, in a spiral in an annular toothconfiguration, 22. A cylindrical extension 26 has a no-go shoulder 27(FIG. 3) thereon which contacts the end 19A of the gear member 19 whenthe cylindrical members 12, 13 are moved to the normally retractedposition, as shown in FIG. 1, to thereby limit travel of the movingcylindrical member in one direction, i.e., when the cylindrical member12 is moved by the lever 33 from the expanded position, FIG. 2, to theretracted position, FIG. 1.

Companion inter-engaging teeth members 21 are provided circularly arounda portion of a ring component 21A of the lever 33 for inter-engagementwith the teeth 20 on the gear member 19 of the first elongatecylindrical member 12.

The extension member 26 has a series of outwardly protruding wingmembers, 28A, 28B which are inserted in companion slots 29A, 29B on thehousing 11 for securement thereto. An outer seal member 31A andcompanion lip seal 31B, as shown in FIG. 4, prevent transmission ofgasses, and other fluids, from within the passageway 16, when theassembly 10 is within the abdominal cavity, during surgery.

An auxiliary instrument 1, such as a laparoscope, may be insertedthrough the seal member 31B and into the passageway 16, subsequent toinsertion of the assembly 10 within the abdominal cavity andmanipulation of the first elongate cylindrical member 12 to the expandedouter diameter 18, as shown in FIG. 2.

Now referring to FIGS. 3 and 3A, a sleeve portion 25 is definedimmediate the distal end of the first elongate cylindrical member 12 andhas a series of radially extending serrated flexing members 23 thereonwith openings 24 inter-defined there between. A serration 23A is cut oneach of the flexing members 23 to permit flexing movement to theexpanding outer diameter position 18.

OPERATION

When it is desired to insert the trocar assembly 10 into the abdominalwall through an incision, or the like, during surgery, the assembly 10is inserted therein by the surgeon simply grasping the housing 11 andinserting the assembly 10 through such incision, or opening. Thereafter,prior to introduction of the auxiliary instrument I through the assembly10, the lateral and non-rotating lever 33 is contacted by the finger orthumb of the surgeon and moved from the position shown in FIG. 3,backwardly, to the position shown in FIG. 3A. Accordingly, as thecontrol 33 is manipulated, the teeth 21 in the ring 21A will travelacross the companion inter-engaging teeth 20 in the teeth configuration22 of the gear member 19, such that the first elongate cylindricalmember 12 moves non-rotatably and laterally away from the no-go shoulder27 on the cylindrical extension 26. Because the first and secondcylindrical members 12, 13 are attached one to another by means of thesecurements 30 at the distal end of the assembly 10, movement of thefirst elongate cylindrical member 12 relative to the second member, 13,will cause the sleeve portion 25 flexing members 23 to be urged radiallyoutwardly from the cylindrical member 12 from the retracted outerdiameter of position 17 (FIG. 1) to the expanded outer diameter of 18(FIG. 2). In the position shown in FIG. 2, the trocar assembly 10 thusresists removal from the abdominal wall W in the cavity, during surgery.

The apparatus may be moved from the position shown in FIG. 2 to theposition shown in FIG. 1 by reversing the procedure described above, andthe assembly 10 completely withdrawn from the abdominal wall W.

Although the invention has been described in terms of specifiedembodiments which are set forth in detail, it should be understood thatthis is by illustration only and that the invention is not necessarilylimited thereto, since alternative embodiments and operating techniqueswill become apparent to those skilled in the art and view of thedisclosure. Accordingly, modifications are contemplated which can bemade without departing from the spirit of the described invention.

What is claimed and desired to be secure by Letters Patent is:
 1. Asleeve for insertion of a surgical instrument into a bodily cavitythrough an incision in a body, the sleeve comprising:a housing; an outercylindrical member coupled to the housing and including a radiallyexpandable member thereon for selective expansion to resist removal ofthe sleeve from the bodily cavity; an inner cylindrical memberconcentrically disposed within the outer cylindrical member and securedthereto, the inner cylindrical member being secured to and stationaryrelative to the housing and having a passage extending therethrough forpassage of the surgical instrument; a lever carried by the housing andcoupled to the outer cylindrical member by gear teeth on the outercylindrical member and inter-engaging gear teeth on the lever, whereinmanipulation of the lever causes the outer sleeve to move relative tothe housing and inner sleeve and the selective expansion of the radiallyexpandable member; and a seal means carried in the passage to preventescape of fluids from the bodily cavity.
 2. The surgical sleeveaccording to claim 1 wherein the radially expandable member comprises aseries of serrated flexing members formed on the outer cylindricalmember.
 3. The surgical sleeve according to claim 1 wherein the sealmeans is a lip seal.
 4. A sleeve for insertion of a surgical instrumentinto a bodily cavity through an incision in a body, the sleevecomprising:a housing; an outer cylindrical member coupled to the housingand including a series of radially expandable flexing members forselective expansion to resist removal of the sleeve from the bodilycavity, the outer cylindrical member having gear teeth at its upper end;an inner cylindrical member concentrically disposed within the outercylindrical member and secured thereto, the inner cylindrical memberbeing secured to and stationary relative to the housing and having apassage extending therethrough for passage of the surgical instrument; alever pivotally coupled to the housing and coupled to the outercylindrical member by gear teeth on the lever inter-engaging with thoseon the outer cylindrical member to cause the outer cylindrical member tomove relative to the housing and inner cylindrical member and theselective expansion of the radially expandable member; and a seal meanscarried in the passage to prevent escape of fluids from the bodilycavity.
 5. The surgical sleeve according to claim 4 wherein the sealmeans is a lip seal.
 6. A sleeve for insertion of a surgical instrumentinto a bodily cavity through an incision in a body, the sleevecomprising:a housing; an outer cylindrical member coupled to the housingand including a series of radially expandable flexing members forselective expansion to resist removal of the sleeve from the bodilycavity; a gear member carried by the outer cylindrical member; an innercylindrical member concentrically disposed within the outer cylindricalmember and secured thereto, the inner cylindrical member being securedto and stationary relative to the housing and having a passage extendingtherethrough for passage of the surgical instrument; a lever pivotallymounted to the housing and having gear teeth thereon for interengagementwith the gear member on the outer cylindrical member to cause the outercylindrical member to move relative to the housing and inner sleeve andthe selective expansion of the radially expandable flexing members; anda lip seal carried in the passage to prevent escape of fluids from thebodily cavity.
 7. The surgical sleeve according to claim 6 wherein thegear member on the outer cylindrical member comprises a helicallythreaded ring.